Attached is the recent NEJM article on prostate Ca screening .
It is almost the same with the recent MUC presentation .
Note the following:
1. The ERSPC trial, although showed 20% mortality benefit, the absolute difference was 0.7 deaths per 1000 men. Furthermore, 1410 men would need to be screened to prevent 1 death from prostate cancer. 48 men need to be treated to prevent that 1 death. Screening did not result in decreased overall or prostate-cancer mortality among men between the ages of 50 and 54 years or those between the ages of 70 and 74 years.
2. The PLCO trial - had contamination and a large number of the control p[opulation had undergone pre-screening
3. The Goteberg trial, although showed reduction in the risk of death from prostate cancer with screening ~ 44%; there was no difference in overall mortality of both arms.
NOTE THE CLINICAL POINTS AT THE END OF THE PAPER:
• The introduction of prostate-specific antigen (PSA) testing has nearly doubled the lifetime risk of receiving a diagnosis of prostate cancer.
• A substantial proportion of PSA-detected cancers are considered overdiagnosed because they would not cause clinical problems during a man's lifetime.
• Early results from two large, randomized, controlled trials of screening were inconsistent; a European study showed a modest decrease in prostate-cancer mortality, whereas a U.S. study showed no decrease in prostate-cancer mortality.
• Treatments for prostate cancer can lead to complications, including urinary, sexual, and bowel dysfunction.
• Men considering prostate-cancer screening should be informed about the potential benefits and harms of screening and treatment.
Attached below is the recent link to the NEJM article:
http://www.nejm.org/doi/full/10.1056/NEJMcp1103642?query=featured_homeSource:
